{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T20:30:04Z","timestamp":1789072204838,"version":"build-2803163510"},"reference-count":40,"publisher":"American Diabetes Association","issue":"9","license":[{"start":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T00:00:00Z","timestamp":1657756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Maintaining healthy glucose levels is critical for the management of type 1 diabetes (T1D), but the most efficacious and cost-effective approach (capillary self-monitoring of blood glucose [SMBG] or continuous [CGM] or intermittently scanned [isCGM] glucose monitoring) is not clear. We modeled the population-level impact of these three glucose monitoring systems on diabetes-related complications, mortality, and cost-effectiveness in adults with T1D in Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We used a Markov cost-effectiveness model based on nine complication states for adults aged 18\u201364 years with T1D. We performed the cost-effectiveness analysis from a single-payer health care system perspective over a 20-year horizon, assuming a willingness-to-pay threshold of CAD 50,000 per quality-adjusted life-year (QALY). Primary outcomes were the number of complications and deaths and the incremental cost-effectiveness ratio (ICER) of CGM and isCGM relative to SMBG.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>An initial cohort of 180,000 with baseline HbA1c of 8.1% was used to represent all Canadians aged 18\u201364 years with T1D. Universal SMBG use was associated with \u223c11,200 people (6.2%) living without complications and \u223c89,400 (49.7%) deaths after 20 years. Universal CGM use was associated with an additional \u223c7,400 (4.1%) people living complications free and \u223c11,500 (6.4%) fewer deaths compared with SMBG, while universal isCGM use was associated with \u223c3,400 (1.9%) more people living complications free and \u223c4,600 (2.6%) fewer deaths. Relative to SMBG, CGM and isCGM had ICERs of CAD 35,017\/QALY and 17,488\/QALY, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Universal use of CGM or isCGM in the Canadian T1D population is anticipated to reduce diabetes-related complications and mortality at an acceptable cost-effectiveness threshold.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc21-2341","type":"journal-article","created":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T11:18:39Z","timestamp":1657797519000},"page":"2012-2019","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":26,"title":["Population-Level Impact and Cost-effectiveness of Continuous Glucose Monitoring and Intermittently Scanned Continuous Glucose Monitoring Technologies for Adults With Type 1 Diabetes in Canada: A Modeling Study"],"prefix":"10.2337","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0895-5752","authenticated-orcid":false,"given":"Michael A.","family":"Rotondi","sequence":"first","affiliation":[{"name":"1School of Kinesiology and Health Science, York University, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Octavia","family":"Wong","sequence":"additional","affiliation":[{"name":"1School of Kinesiology and Health Science, York University, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Riddell","sequence":"additional","affiliation":[{"name":"1School of Kinesiology and Health Science, York University, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Perkins","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology, Department of Medicine, University of Toronto, Toronto, 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